Title Page

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Section A - Preliminary Assessment

  • 1) Job / Task Description

  • Note 1.
    Many manual handling operations will involve negligible risk. When considering if the operation presents a risk of injury, refer to the diagram from HSE guidelines, which refer to straight forward and infrequent operations.

  • 2) Can the operation be avoided?

  • 3) Can the operation be automated or mechanically assisted at reasonable cost?

  • Note 2.
    If an operation can be avoided or automated/mechanically assisted at reasonable cost, then such control measures must be put in place. Where this is not the case, a full assessment will be required.

  • Is a detailed assessment needed? (I.e is there a potential risk of injury and are HSE MAC guideline limits exceeded?)

  • Note 3.
    If 'no' then the assessment need go no further. If 'yes' then a detailed assessment should be carried out. A competent person should carry out the assessment. Where an affirmative response is given then the action required should be stated in the table provided. After an action is completed , it should be signed off.

Manual Handling Assessment Form

Section B - Detailed Assessment

  • Operations covered by this assessment (detailed description):

  • Location(s):

  • Personnel Involved:

  • Date of Assessment:

The Tasks - Do they involve:

  • Holding loads away from the trunk?

  • Twisting?

  • Stooping?

  • Reaching upwards?

  • Large vertical movements?

  • Long carrying distances?

  • Strenuous pushing or pulling?

  • Unpredictable movement of loads?

  • Repetitive handling?

  • Insufficient rest or recovery?

  • A work rate imposed by a process?

The Loads - Are they:

  • Heavy?

  • Bulky/Unwieldy?

  • Difficult to grasp?

  • Unstable/Unpredictable?

  • Intrinsically harmful (e.g. sharp, hot)?

The Working Environment - Are there:

  • Constraints on posture?

  • Poor floors?

  • Variations in level?

  • Hot/Cold/Humid conditions?

  • Strong air movements?

  • Poor lighting conditions?

Individual Capability - Does the job:

  • Require unusual capability?

  • Hazard those with a health problem?

  • Hazard those who are pregnant?

  • Require special information/trainings?

Other Factors:

  • Is movement or posture hindered by clothing or personal protective equipment?

Section C - Existing Control Measures / Safe System of Work

  • List as bullet points; include details of training, any lifting equipment and PPE):

Section D - Overall Assessment of the Risk Injury:

  • Are existing control measures satisfactory?

  • Key To Risk

    Low Risk - Minor impact on health/damage (quickly repaired). Ensure controls are maintained.

    Medium Risk - Moderate impact to health/partial loss of operations. Look to improve control measures.

    High Risk - Disaster/very serious consequences/injury. Stop activity and implement immediate control measures to reduce the risk.

  • Degree of risk?<br><br>

  • Are additional control measures required to reduce the level of risk to the lowest practicable level?

  • Control Details
  • Control Details:

  • Add media

  • Person Responsible:

  • Target Date for Control Implementation:

  • Date of Completion:

  • Assessor Name:

  • Assessor Name:

  • Assessment Review Due Date:

ASSESSMENT REVIEW

  • Date:

  • Review Completed By:

  • Review Outcome (where significant changes have occurred, a new record sheet should be used):

  • Next Assessment Review Date:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.